HomeMy WebLinkAboutBLD1986-00236 FLOOD CERTIFICATEa a aJEFFERSON COUNTY
FLOOD AREA CERTIFICATE
FederaL Emergency Management Agency
NatLonaL FLood lnsurance Progra.m
DIRECTIONS
The responsLbLe offLcLaL shaLL compLete those portlons of
Sectlon 1 where necessary Lnformatlon Ls avalLable Ln the county
records. tn the absence of sufflclent data, a reglstered
professLonaL engLneer, archLtect, or srrveyor shalL compLete_thls-
sectlon. Sectlon 2 shaLL be compLeted by the responslbLe offlclal.
Sectlon 3 shaLL be compLeted by the bulLdlng offlclaL.
/
SECT I ON 1 {
APPL ICANT:L Z
ADDRESS:
TELEPHONE: (hore)( busLness )
If EPRESENTAT IVE (contact ) :
ADDRESS:
TELEPHONE: (home)( UrsLness )
PROPERTY DESCRIPTION
GENERAL LOCATION: T :'^-
LEGAL:
ldentlfLer Number:
Tax ParceL Number (from Pr
ReaL Property DescrLptlon
operty tax statement):
(from property tax statement):
IU
,
S I TE'S D I STANCE FROM IflATERT'.IAY:I
BASE FLOOD ELEVATION (rOO Year fLood LeveL):
SITE'S ELEVATION (grade LeveL ):
SITE tfltTHlN FLOODITAY: Y,a
PROPOSAL
PROPOSED USE: fl ResldentlaL \ hloblLe Home D CommerclaL D Industrlal
tr AgrlcuLturaL tl Storate tr Other (Ldentlfy:
FLOODPROOF I NG I.IEASLJRES :
LandfL L L
PoLe, pler, or pLLe
ParaLLeL foundatlon waLls
Extended waLLs and basement
ALternatlve ( Ldentlfy) :
YES
tr
D
tr
D
tr
NO
tr
tr
u
D
tr
50 b0 [*
t1r* /
bJ" tzf;(lL>go Qq)
I
L
)a
F.I.A. I\IAP
PANEL AND FLOOD SOURCE:
ZONE:
/L ,/{
\ACKNOI'JLEDGEITTIENT
the Lnformatlon provlded Ln sectlon 1 Ls true andI verLfy
correct.
TsLgnature )
REGTSTERED PROFESSI ONAL :
T I TLE:LICENSE NUMBER:
SECTION 2
CONDITIONS OF APPROVAL
the Lowest floor shaLL be
(aate )
1
1
The degree o
consLdered reason
approvaL shaLL no
for an f Lood
protectlon requlred bY
retuLatory purposes.
LLabLLLty on the PartresuLts from reLLance
feet above
thls certLfLcate Ls
ThLs certLfLcate
of Jefferson CountY
on thls certLfLcate.
6-/-
the condltlons of the
*ffiThe helght of
grade.
,/A
2
Over-the-top tles be pnovlded at each of the four corners of
the moblle home, wlth two addltlonaL tles per slde at Lnter-
medlate Locatlons, and wlth homes Less than flfty feet Long 'regulrlng onLy one addltlonal tle per slde.
Frame tles be provlded at each corner of the home wlth flve
addltlonaL tles per slde at Lntermedlate polnt, wlth moblLe
homes Less than fLfty feet Long requlrlng onLy four addltLonaL
tles per slde.
ALL components of the anchorlng system be capabLe of carrylng
a force of 4,BOO pounds.
Any addltlons to such homes be sLmLLarLy anchored.
ACKNOIlLEDGEI\IENT
3
4
f fLood
abLe for
t create
age that
edaLtnae
IBLE CFFICIAL:
TITLE
fLood
verlfy that the
area. certlfLcate.
DEPARTI'ENT:
SECT I ON 3
AS-BU ILT CERT IF ICAT I ON
structure complLes wlth
( sLgnature )
BUILDING OFFICIAL:
(date )
I a